Abstract:
BACKGROUND/AIMS:Cognitive decline is a defining feature of dementia. We sought to determine if a single baseline cognitive test score or change in test score over time is more strongly associated with risk of dementia hospitalization. We also sought to compare short- and long-term dementia risk. METHODS:Prospective cohort study of 9,399 individuals from the Atherosclerosis Risk in Communities Study (median 10 years of follow-up). Cognition was assessed at two time points (6 years apart) using three tests: Delayed Word Recall Test (DWRT), Digit Symbol Substitution Test (DSST), and Word Fluency Test. Dementia hospitalizations were determined using ICD-9 codes. RESULTS:Baseline cognitive test scores were associated with both short-term and long-term risk of dementia. The association of 6-year change in cognitive test score with dementia risk was stronger than that of individual test scores at a single visit [change from highest to lowest tertile, DWRT: hazard ratio = 6.45 (95% confidence interval = 1.80-23.08); DSST: hazard ratio = 10.94 (95% confidence interval = 3.07-38.97)]. CONCLUSIONS:In this community-based population, 6-year changes in cognitive scores were more strongly associated with risk of incident dementia hospitalization than baseline scores, although single DWRT and DSST scores were predictive. Our findings support the contention that cognitive changes may precede clinical dementia by a decade or more.
journal_name
Neuroepidemiologyjournal_title
Neuroepidemiologyauthors
Schneider AL,Gottesman RF,Mosley T,Alonso A,Knopman DS,Coresh J,Sharrett AR,Selvin Edoi
10.1159/000342308subject
Has Abstractpub_date
2013-01-01 00:00:00pages
117-24issue
2eissn
0251-5350issn
1423-0208pii
000342308journal_volume
40pub_type
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